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Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger

AIMS: To assess the clinical profile and nutritional status of infants with cystic fibrosis (CF) and track their nutritional outcomes with treatment. MATERIALS AND METHODS: This retrospective study was conducted in a tertiary-care institute in South India. Demographic and clinical information were c...

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Autores principales: Thomas, Leenath, John, Shincy T., Lionel, B Arul P., Rebekah, Grace, Kumar, Madhan, Punnen, Anu, Varkki, Sneha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208186/
https://www.ncbi.nlm.nih.gov/pubmed/34195137
http://dx.doi.org/10.4103/jfmpc.jfmpc_2421_20
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author Thomas, Leenath
John, Shincy T.
Lionel, B Arul P.
Rebekah, Grace
Kumar, Madhan
Punnen, Anu
Varkki, Sneha
author_facet Thomas, Leenath
John, Shincy T.
Lionel, B Arul P.
Rebekah, Grace
Kumar, Madhan
Punnen, Anu
Varkki, Sneha
author_sort Thomas, Leenath
collection PubMed
description AIMS: To assess the clinical profile and nutritional status of infants with cystic fibrosis (CF) and track their nutritional outcomes with treatment. MATERIALS AND METHODS: This retrospective study was conducted in a tertiary-care institute in South India. Demographic and clinical information were collected. The nutritional status and treatment outcome was assessed by Z-scores for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) at diagnosis and follow-up. RESULTS: Nineteen infants with CF had mean follow-up duration of 9.7 ± 8.7 months. There was a mean delay of 2.9 ± 2.1 months from symptom onset to diagnosis, by which time infants were severely malnourished (mean WAZ -4.68 ± 1.8). Pneumonia, summer dehydration with electrolyte abnormalities (42.1%), and a combination of anemia, hypoalbuminemia, and malnutrition (42.1%) were the predominant features. Significant weight loss had been recorded in undiagnosed infants by second month of life before symptom onset. At follow-up, there was a remarkable improvement in WAZ (P 0.001), but not LAZ and WLZ. There was a high mortality rate of 37% in these infants. CONCLUSIONS: Malnutrition is a significant morbidity in infants with CF in India. There was significant improvement of WAZ with treatment, but it lagged behind the recommended targets. There is an opportunity for identification of CF infants at the time of vaccination at six and ten weeks of age, by the primary care physician and pediatrician. Screening of young infants having failure to thrive in the immunization clinic may be a strategy for early diagnosis of infants with severe CF phenotype.
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spelling pubmed-82081862021-06-29 Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger Thomas, Leenath John, Shincy T. Lionel, B Arul P. Rebekah, Grace Kumar, Madhan Punnen, Anu Varkki, Sneha J Family Med Prim Care Original Article AIMS: To assess the clinical profile and nutritional status of infants with cystic fibrosis (CF) and track their nutritional outcomes with treatment. MATERIALS AND METHODS: This retrospective study was conducted in a tertiary-care institute in South India. Demographic and clinical information were collected. The nutritional status and treatment outcome was assessed by Z-scores for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) at diagnosis and follow-up. RESULTS: Nineteen infants with CF had mean follow-up duration of 9.7 ± 8.7 months. There was a mean delay of 2.9 ± 2.1 months from symptom onset to diagnosis, by which time infants were severely malnourished (mean WAZ -4.68 ± 1.8). Pneumonia, summer dehydration with electrolyte abnormalities (42.1%), and a combination of anemia, hypoalbuminemia, and malnutrition (42.1%) were the predominant features. Significant weight loss had been recorded in undiagnosed infants by second month of life before symptom onset. At follow-up, there was a remarkable improvement in WAZ (P 0.001), but not LAZ and WLZ. There was a high mortality rate of 37% in these infants. CONCLUSIONS: Malnutrition is a significant morbidity in infants with CF in India. There was significant improvement of WAZ with treatment, but it lagged behind the recommended targets. There is an opportunity for identification of CF infants at the time of vaccination at six and ten weeks of age, by the primary care physician and pediatrician. Screening of young infants having failure to thrive in the immunization clinic may be a strategy for early diagnosis of infants with severe CF phenotype. Wolters Kluwer - Medknow 2021-05 2021-05-31 /pmc/articles/PMC8208186/ /pubmed/34195137 http://dx.doi.org/10.4103/jfmpc.jfmpc_2421_20 Text en Copyright: © 2021 Journal of Family Medicine and Primary Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Thomas, Leenath
John, Shincy T.
Lionel, B Arul P.
Rebekah, Grace
Kumar, Madhan
Punnen, Anu
Varkki, Sneha
Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title_full Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title_fullStr Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title_full_unstemmed Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title_short Effect of malnutrition in infants with cystic fibrosis in India: An underestimated danger
title_sort effect of malnutrition in infants with cystic fibrosis in india: an underestimated danger
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208186/
https://www.ncbi.nlm.nih.gov/pubmed/34195137
http://dx.doi.org/10.4103/jfmpc.jfmpc_2421_20
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